Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry Study

Abstract Introduction Peripheral neuropathic pain after nerve injury (PNI) caused by surgery or trauma can severely impact daily life. The high-concentration capsaicin patch (HCCP, 179 mg) is a topical therapy approved for peripheral neuropathic pain, including PNI. This study utilizes data from the...

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Main Authors: Michael A. Überall, Christian Simanski, Mike Zellnig, Mariëlle Eerdekens, Sylvia Engelen, Myriam Heine, Fabienne Percot, Rita Freitas, Lucia Garcia Guerra, Tamara Quandel
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-06-01
Series:Pain and Therapy
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Online Access:https://doi.org/10.1007/s40122-025-00752-4
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author Michael A. Überall
Christian Simanski
Mike Zellnig
Mariëlle Eerdekens
Sylvia Engelen
Myriam Heine
Fabienne Percot
Rita Freitas
Lucia Garcia Guerra
Tamara Quandel
author_facet Michael A. Überall
Christian Simanski
Mike Zellnig
Mariëlle Eerdekens
Sylvia Engelen
Myriam Heine
Fabienne Percot
Rita Freitas
Lucia Garcia Guerra
Tamara Quandel
author_sort Michael A. Überall
collection DOAJ
description Abstract Introduction Peripheral neuropathic pain after nerve injury (PNI) caused by surgery or trauma can severely impact daily life. The high-concentration capsaicin patch (HCCP, 179 mg) is a topical therapy approved for peripheral neuropathic pain, including PNI. This study utilizes data from the German Pain e-Registry (GPeR) to investigate the real-world effectiveness of HCCP in managing PNI across multiple treatments over 1 year. Methods CASPAR is a retrospective, non-interventional cohort study investigating patients with peripheral neuropathic pain treated with HCCP. The present analysis included 499 patients with PNI who received ≥ 1 HCCP with ≥ 12 months of follow-up. Key measures included pain intensity, quality of life (QoL), affective distress, sleep disturbances, and overall functioning. Furthermore, analgesic use and adverse events associated with HCCP treatment were evaluated. Results The mean average daily pain intensity (API) decreased from 52.5 mm on the visual analog scale (VAS) at baseline to 21.5 mm at month 12 in patients receiving four HCCPs. At month 12, a ≥ 30% reduction in API was observed in 25.8%, 44.9%, 85.3%, and 97.8% of patients receiving one, two, three, and four HCCP treatments, respectively. Significant improvements were also noted in physical and mental QoL, sleep, mood, and daily functioning. Patients receiving three or four HCCP treatments maintained pain relief and symptom improvements over the 12-month period, whereas those who discontinued treatment after one or two treatments experienced symptom rebound. In addition, repeated HCCP treatments were associated with a marked reduction in concomitant analgesic use and an increase in days of normal activities. Adverse events were mild-to-moderate application-site reactions, consistent with the well-established safety profile of HCCP. Conclusions HCCP treatment is associated with reductions in pain intensity and improvements in sleep, mood, and overall QoL in patients with PNI. These benefits are amplified with continued treatment and are accompanied by reduced use of concomitant analgesics and more days of usual activities, although a direct causal relationship cannot be confirmed within the context of this observational study. Clinical Trial Registration EU PAS number: EUPAS1000000106.
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spelling doaj-art-ef94ac64ec0e4c23b2f084e7d158f8292025-08-20T04:01:46ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2025-06-011441399141610.1007/s40122-025-00752-4Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry StudyMichael A. Überall0Christian Simanski1Mike Zellnig2Mariëlle Eerdekens3Sylvia Engelen4Myriam Heine5Fabienne Percot6Rita Freitas7Lucia Garcia Guerra8Tamara Quandel9Institute of Neurological SciencesDepartment Foot & Ankle Surgery, Member of the Chair for Orthopaedic and Trauma Surgery, GFO-Clinic Mettmann South, St. Martinus Hospital Langenfeld, University Witten/HerdeckeClinic for Pain Medicine, BG Klinikum DuisburgGrünenthal GmbHGrünenthal GmbHGrünenthal GmbHLaboratoires Grünenthal S.A.S.Grünenthal S.A.Grünenthal Pharma S.A.Grünenthal GmbHAbstract Introduction Peripheral neuropathic pain after nerve injury (PNI) caused by surgery or trauma can severely impact daily life. The high-concentration capsaicin patch (HCCP, 179 mg) is a topical therapy approved for peripheral neuropathic pain, including PNI. This study utilizes data from the German Pain e-Registry (GPeR) to investigate the real-world effectiveness of HCCP in managing PNI across multiple treatments over 1 year. Methods CASPAR is a retrospective, non-interventional cohort study investigating patients with peripheral neuropathic pain treated with HCCP. The present analysis included 499 patients with PNI who received ≥ 1 HCCP with ≥ 12 months of follow-up. Key measures included pain intensity, quality of life (QoL), affective distress, sleep disturbances, and overall functioning. Furthermore, analgesic use and adverse events associated with HCCP treatment were evaluated. Results The mean average daily pain intensity (API) decreased from 52.5 mm on the visual analog scale (VAS) at baseline to 21.5 mm at month 12 in patients receiving four HCCPs. At month 12, a ≥ 30% reduction in API was observed in 25.8%, 44.9%, 85.3%, and 97.8% of patients receiving one, two, three, and four HCCP treatments, respectively. Significant improvements were also noted in physical and mental QoL, sleep, mood, and daily functioning. Patients receiving three or four HCCP treatments maintained pain relief and symptom improvements over the 12-month period, whereas those who discontinued treatment after one or two treatments experienced symptom rebound. In addition, repeated HCCP treatments were associated with a marked reduction in concomitant analgesic use and an increase in days of normal activities. Adverse events were mild-to-moderate application-site reactions, consistent with the well-established safety profile of HCCP. Conclusions HCCP treatment is associated with reductions in pain intensity and improvements in sleep, mood, and overall QoL in patients with PNI. These benefits are amplified with continued treatment and are accompanied by reduced use of concomitant analgesics and more days of usual activities, although a direct causal relationship cannot be confirmed within the context of this observational study. Clinical Trial Registration EU PAS number: EUPAS1000000106.https://doi.org/10.1007/s40122-025-00752-4Peripheral nerve injuryPeripheral neuropathic painHigh-concentration capsaicin patchReal-word dataTopical treatment
spellingShingle Michael A. Überall
Christian Simanski
Mike Zellnig
Mariëlle Eerdekens
Sylvia Engelen
Myriam Heine
Fabienne Percot
Rita Freitas
Lucia Garcia Guerra
Tamara Quandel
Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry Study
Pain and Therapy
Peripheral nerve injury
Peripheral neuropathic pain
High-concentration capsaicin patch
Real-word data
Topical treatment
title Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry Study
title_full Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry Study
title_fullStr Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry Study
title_full_unstemmed Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry Study
title_short Progressive Response of Repeated Treatment with High-Concentration (179 mg) Capsaicin Patch in Peripheral Neuropathic Pain After Surgical or Traumatic Nerve Injury: Findings from the 12-Month German CASPAR Registry Study
title_sort progressive response of repeated treatment with high concentration 179 mg capsaicin patch in peripheral neuropathic pain after surgical or traumatic nerve injury findings from the 12 month german caspar registry study
topic Peripheral nerve injury
Peripheral neuropathic pain
High-concentration capsaicin patch
Real-word data
Topical treatment
url https://doi.org/10.1007/s40122-025-00752-4
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